Interdental Care - Dentalelle Tutoring

Interdental Care Dentalelle Tutoring Copyright @ Dentalelle Tutoring - www.dentalelle.com 1 Types of Gingival Embrasures This is the most important! Depending on the size of that space will depend on what interdental aids you will recommend Copyright @ Dentalelle Tutoring - www.dentalelle.com 2

What is the col? Under the contact area between the lingual papilla and facial papilla DIFFERENT from the embrasure The epithelium covering the col is thin and non keratinized Copyright @ Dentalelle Tutoring - www.dentalelle.com 3 Gingivitis

STARTS in the interdental area (or at least has a greater chance of happening) because the col isnt protected very well If bacteria from the plaque is left to sit there, it causes inflammation which is gingivitis Concavities and grooves allow that plaque to hide in those areas a lot easier Copyright @ Dentalelle Tutoring - www.dentalelle.com 4

Copyright @ Dentalelle Tutoring - www.dentalelle.com 5 Assessment What type of anatomy does the patient have? What do the teeth look like and what does the gingiva look like? Does the patient have any crowns? Bridges? Implants? Do some plaque assessments plaque free score for example, or using disclosing tabs Is the patient handicapped? A child? Do they need additional brushing instruction?

**Keep it simple suggest aids that are easy to use, help them increase their oral hygiene steps but dont go overboard, etc Copyright @ Dentalelle Tutoring - www.dentalelle.com 6 Review of Toothbrushing Charters Fones Stillmans

Bass Lets talk , which is which? Copyright @ Dentalelle Tutoring - www.dentalelle.com 7 Floss Waxed stronger, easier to get through contacts Thinner floss helpful in very tight contacts. Special attention must be given to avoid trauma to tissue due to the thin nature

Unwaxed can be hard for the patient to use and can fray BEST TO USE FLOSS BEFORE BRUSHING GINGIVITIS AND PERIO BEGINS IN THE COL AREA WHICH IS WHY FLOSSING IS SO IMPORTANT! Copyright @ Dentalelle Tutoring - www.dentalelle.com 8 When would a floss holder be used? For someone who cant lift their arms

Someone in a wheelchair Someone who has difficulty wrapping the floss around their fingers A teenager with braces Copyright @ Dentalelle Tutoring - www.dentalelle.com 9 When would a floss holder be used? For someone who cant lift their arms Someone in a wheelchair

Someone who has difficulty wrapping the floss around their fingers A teenager with braces Copyright @ Dentalelle Tutoring - www.dentalelle.com 10 What is Superfloss used for? To aid in flossing For those who dont like the string floss

For elderly patients, its a thicker floss Under appliances Copyright @ Dentalelle Tutoring - www.dentalelle.com 11 What is Superfloss used for? To aid in flossing For those who dont like the string floss For elderly patients, its a

thicker floss Under appliances Copyright @ Dentalelle Tutoring - www.dentalelle.com 12 What can knitting yarn be used for? Small spaces Class I embrasures Larger spaces

For implants only Copyright @ Dentalelle Tutoring - www.dentalelle.com 13 What can knitting yarn be used for? Small spaces Class I embrasures Larger spaces often used with a floss threader to get under bridges and appliances

For implants only Copyright @ Dentalelle Tutoring - www.dentalelle.com 14 What is a gauze strip used for? For wide spaces Teeth next to edentulous areas Next to abutment teeth All of the above

Copyright @ Dentalelle Tutoring - www.dentalelle.com 15 What is a gauze strip used for? For wide spaces Teeth next to edentulous areas Next to abutment teeth All of the above Copyright @ Dentalelle Tutoring - www.dentalelle.com

16 What are interdental brushes used for? When spaces are in between the teeth When the teeth have no spaces When papilla is missing For cleaning dentures Copyright @ Dentalelle Tutoring - www.dentalelle.com

17 What are interdental brushes used for? When spaces are in between the teeth *can also be used to apply agents to the area (fluorides, desensitizing, antibacterial, etc) When the teeth have no spaces When papilla is missing

For cleaning dentures Copyright @ Dentalelle Tutoring - www.dentalelle.com 18 What is an end-tufted brush used for? Any hard to reach area, space, and orthodontics Implants only Childrens teeth with the charters method

In conjunction with an electric toothbrush Copyright @ Dentalelle Tutoring - www.dentalelle.com 19 What is an end-tufted brush used for? Any hard to reach area, space, and orthodontics = also bridges, partial dentures, implant abutments, etc. Implants only Childrens teeth with the charters method

In conjunction with an electric toothbrush Copyright @ Dentalelle Tutoring - www.dentalelle.com 20 Interdental tip, what is this? Smaller bristles attached to the end of a handle Attachment on an electric toothbrush A flexible rubber tip attached to a handle

None of the above Copyright @ Dentalelle Tutoring - www.dentalelle.com 21 Interdental tip, what is this? Smaller bristles attached to the end of a handle Attachment on an electric toothbrush A flexible rubber tip attached to a handle

None of the above Copyright @ Dentalelle Tutoring - www.dentalelle.com 22 What can a toothpick in a holder be used for? Furcation areas Recessions Denture cleaning

Tight spaces Copyright @ Dentalelle Tutoring - www.dentalelle.com 23 What can a toothpick in a holder be used for? Furcation areas Recessions Denture cleaning

Tight spaces Copyright @ Dentalelle Tutoring - www.dentalelle.com 24 What can be used if the interdental papilla is missing? Floss Small interproximal brush Rubber tip brush

Wooden interdental cleaner Copyright @ Dentalelle Tutoring - www.dentalelle.com 25 What can be used if the interdental papilla is missing? Floss Small interproximal brush Rubber tip brush Wooden interdental cleaner

Copyright @ Dentalelle Tutoring - www.dentalelle.com 26 Saliva + Dentifrices Copyright @ Dentalelle Tutoring - www.dentalelle.com 27 Toothpastes Reduce biofilm formation Reduce gingivitis Prevention of caries

Remineralization of early caries Reduction of dentin hypersensitivity Reduction of supragingival calculus Copyright @ Dentalelle Tutoring - www.dentalelle.com 28 Toothpastes cannot: Reduce subgingival calculus

Promote remineralization Prevent caries Reduce gingivitis Copyright @ Dentalelle Tutoring - www.dentalelle.com 29 Toothpastes cannot: Reduce subgingival calculus Promote remineralization

Prevent caries Reduce gingivitis Copyright @ Dentalelle Tutoring - www.dentalelle.com 30 What are the two agents that reduce biofilm formation? Triclosan and zinc citrate Irrigation and triclosan

Humectant and astringent Zinc citrate and humectant Copyright @ Dentalelle Tutoring - www.dentalelle.com 31 What are the two agents that reduce biofilm formation? Triclosan and zinc citrate (triclosan is the primary agent shown to reduce gingivitis) Irrigation and triclosan

Humectant and astringent Zinc citrate and humectant Copyright @ Dentalelle Tutoring - www.dentalelle.com 32 What is the most common agent used to reduce dentin hypersensitivity? Zinc citrate Triclosan

Sodium hexametaphosphate Potassium nitrate Copyright @ Dentalelle Tutoring - www.dentalelle.com 33 What is the most common agent used to reduce dentin hypersensitivity? Zinc citrate Triclosan Sodium hexametaphosphate

Potassium nitrate Copyright @ Dentalelle Tutoring - www.dentalelle.com 34 What is NOT an agent found in toothpaste to reduce supracalculus formation? Pyrophosphate salts Zinc salts Hydroxide

Triclosan Copyright @ Dentalelle Tutoring - www.dentalelle.com 35 What is NOT an agent found in toothpaste to reduce supracalculus formation? Pyrophosphate salts Zinc salts Hydroxide

Triclosan ..and sodium hexametaphosphate is also shown to reduce supracalculus formation Copyright @ Dentalelle Tutoring - www.dentalelle.com 36 In toothpastes: Detergent (foaming agent) 1-2% Binder (thickener) 102% Cleaning and polishing agent (abrasive) 20-40%

Humectant 20-40% Preservative 2-3% Flavouring (sweetener) 1-1.5% Water 20-40% Therapeutic agent 1-2% Copyright @ Dentalelle Tutoring - www.dentalelle.com

37 Joe has come to you for his regular 6 month cleaning and he wants to try a new toothpaste. Which one do you recommend? Selection depends on what the client needs Anything approved by the dental association Anything with fluoride Anything that inhibits inflammation Copyright @ Dentalelle Tutoring - www.dentalelle.com

38 Joe has come to you for his regular 6 month cleaning and he wants to try a new toothpaste. Which one do you recommend? Selection depends on what the client needs is caries a concern (fluoride), dentin hypersensitivity, inflammation, calculus, etc. Anything approved by the dental association Anything with fluoride Anything that inhibits inflammation Copyright @ Dentalelle Tutoring - www.dentalelle.com

39 Mouth rinses are used to: Inhibit intraoral microorganisms Reduce intraoral microorganisms To increase aerosol production of the ultrasonic scaler To increase aerosol production of the high speed handpiece Copyright @ Dentalelle Tutoring - www.dentalelle.com 40

Mouth rinses are used to: Inhibit intraoral microorganisms Reduce intraoral microorganisms To increase aerosol production of the ultrasonic scaler To increase aerosol production of the high speed handpiece Copyright @ Dentalelle Tutoring - www.dentalelle.com 41 What does an astringent do in

chemotherapeutic agents? Neutralizes odor Alleviates pain Shrinks tissues Reduction of gingivitis Copyright @ Dentalelle Tutoring - www.dentalelle.com 42 What does an astringent do in chemotherapeutic agents?

Neutralizes odor - deodorizing Alleviates pain - anodyne Shrinks tissues - astringent Reduction of gingivitis gingival health Copyright @ Dentalelle Tutoring - www.dentalelle.com 43 What is cariostatic?

Inhibits demineralization Deposits fluoride ions on enamel Deposits fluoride ions in carious lesions Interferes with cell metabolism Copyright @ Dentalelle Tutoring - www.dentalelle.com 44 What is cariostatic? Inhibits demineralization AND enhances remineralization

Deposits fluoride ions on enamel Deposits fluoride ions in carious lesions Interferes with cell metabolism Copyright @ Dentalelle Tutoring - www.dentalelle.com 45 Chlorhexidine Broad antibacterial activity

Binds to oral and soft tissues Attaches to the bacterial cell membrane, thereby damaging the cytoplasm causing lysis Binds to pellicle preventing biofilm accumulation Bactericidal (kills) AND bacteriostatic (interferes) Lasts 8-12 hours!! Antimicrobial and anti gingivitis agent

Copyright @ Dentalelle Tutoring - www.dentalelle.com 46

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